Open AccessEUS-guided through-the-needle microbiopsy of pancreatic cysts: Technical aspects (with video)
Author(s) -
Bojan Kovačević,
Evangelos Kalaitzakis,
Pia Klausen,
Lene Brink,
Hazem Hassan,
John Gásdal Karstensen,
Peter Vilmann
Publication year - 2020
Publication title -
endoscopic ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.883
H-Index - 24
eISSN - 2303-9027
pISSN - 2226-7190
DOI - 10.4103/eus.eus_12_20
Subject(s) - medicine , cyst , serous fluid , radiology , serous cystadenoma , pancreatitis , sampling (signal processing) , pancreatic cyst , general surgery , surgery , pathology , filter (signal processing) , computer science , computer vision
Pancreatic cystic lesions are frequently encountered and diagnostically challenging as some of the cysts may have malignant potential (mucinous) while others are completely benign (serous). EUS-guided through-the-needle biopsy (EUS-TTNB) of the cyst wall has recently been introduced as an alternative to cyst fluid cytology. Several studies have shown that microbiopsies outperform cytology in terms of distinction between mucinous and nonmucinous lesions, but also in determining the specific cyst diagnosis. However, little is known about the technical aspects of tissue sampling with TTNB. Herein, we summarize our experience with the procedure in a tertiary referral center and discuss indications, technical aspects, and safety of the procedure. Most adverse events (AEs) associated with the procedure are mild, but there is emerging evidence that the rate of postprocedural pancreatitis is higher compared to standard fine-needle aspiration. The added diagnostic yield should therefore be placed in perspective with an increased risk of AEs. Prospective studies are warranted to fully identify which patient groups could benefit from EUS-TTNB.